DISCUSSION
Left ventricular pseudoaneurysm occurs when the rupture of all cardiac layers is contained by pericardial adhesions or fibrotic tissue. Frances et al.,¹ in a systematic review in this group of patients, described that the main symptoms presented are congestive heart failure, chest pain and dyspnea, compatible with the signs verified in the present report.
Among the determining factors for the occurrence of pseudoaneurysm, AMI stands out, through rupture of the ventricular wall with absence of hemopericardium and cardiac tamponade, especially in AMI affecting the inferior wall². The presentation can be late, varying from months to years.³
The risk of rupture demonstrated in cases of pseudoaneurysm producing hemorrhagic events is 35-40%. However, due to the risk of imminent mortality, surgical approach is imperative after diagnosis. It is important to note that most cases are managed in the chronic phase and about 10% are asymptomatic.4
The surgical team opted for preoperative cinecoronarioangiography. Despite the diagnostic suspicion and the inherent risks, left ventriculography was not performed, which should be considered in the approach of these patients.5